Reviewed 2026/2027| Complete 130
Questions and Correct Detailed
Answers With Rationales |
Guaranteed Pass A+(Brand New!!)
1. The nurse is examining an infant for possible cryptorchidism. Which exam
technique should be used?
A. Place the infant in side-lying to facilitate the exam
B. Hold the penis and retract the foreskin gently
C. Cleanse the penis with an antiseptic-soaked pad
D. Place the infant in warm room and use a calm approach -
ANSWER✔️-D. Place the infant in warm room and use a calm
approach
2. The nurse is planning care for a client at 30-weeks gestation who is
experiencing preterm labor. What maternal prescription is most important in
preventing this fetus from developing respiratory distress syndrome?
A. Betamethasone (Celestone) 12 mg deep IM
B. Butorphanol 1 mg IV push q2h PRN pain
C. Ampicillin 1 Gram IV push q8h
D. Terbutaline (Brethine) 0.25 mg subcutaneously q15 minutes x3 -
ANSWER✔️-A. Betamethasone (Celestone) 12 mg deep IM
3. A 3-month-old with myelomeningocele and atonic bladder is catheterized
every 4 hours to prevent urinary retention. The home health nurse notes that
the child has developed episodes of sneezing, urticaria, watery eyes, and a
rash in the diaper area. What action is most important for the nurse to take?
A. Auscultate the lungs for respiratory pneumonia.
B. Draw blood to analyze for streptococcal infection
C. Change to latex-free gloves when handling infant
D. Apply zinc oxide to perineum with each diaper change -
ANSWER✔️-C. Change to latex-free gloves when handling infant
,4. The nurse is caring for a female client, a primigravida, with preeclampsia.
Findings include +2 proteinuria, BP 172/112 mmHg, facial and hand
swelling, complaints of blurry vision and a severe frontal headache. Which
medication should the nurse anticipate for this client?
A. Clonidine hydrochloride
B. Carbamazepine
C. Furosemide
D. Magnesium sulfate - ANSWER✔️-D. Magnesium sulfate
5. A client at 35-weeks gestation complains of a "pain whenever the baby
moves." On assessment, the nurse notes the client's temperature to be
101.2F, with severe abdominal or uterine tenderness on palpation. The nurse
knows that these findings are indicative of what condition?
A. Round ligament strain
B. Chorioamnionitis
C. Abruptio placenta
D. Viral infection. - ANSWER✔️-B. Chorioamnionitis
6. A male infant with a 2-day history of fever and diarrhea is brought to a clinic
by his mother who tells the nurse that the child refuses to drink anything.
The nurse determines that the child has a weak cry with no tears. Which
prescription is most important to implement?
A. Provide a bottle of electrolyte solution
B. Infuse normal saline intravenously
C. Administer an antipyretic rectally
D. Apply external cooling blanket - ANSWER✔️-B. Infuse normal
saline intravenously
7. A 6-month old child who had a cleft-lip repair has elbow restraints in place.
What nursing intervention should the nurse plan to implement?
A. remove restraints q4h for 30 minutes and place gloves on the child's
hands
B. record observations of the restraints q2h and ensure that they are in
place at all times
C. obtain the HCP advice as to when the restraints should be removed
D. remove restraints one at a time to provide ROM exercises -
ANSWER✔️-D. remove restraints one at a time to provide ROM
exercises
,8. A new mother calls the nurse stating that she wants to start feeding her 6-
month-old child something besides breast milk, but is concerned that the
infant is too young to start eating solid foods. How should the nurse
respond?
A. encourage the mother to schedule a developmental assessment of the
infant
B. advise the mother to wait at least another month before starting any
solid foods
C. instruct the mother to offer a few spoons of 2-3 pureed fruit at each
meal
D. reassure the mother that the infant is old enough to eat iron-fortified
cereal - ANSWER✔️-D. reassure the mother that the infant is old
enough to eat iron-fortified cereal
9. While caring for a laboring client on continuous fetal monitoring, the nurse
notes a fetal heart rate pattern that falls and rises abruptly with a "V" shaped
appearance. What action should the nurse take first?
A. Prepare for a potential cesarean
B. Allow the client to begin pushing
C. Administer oxygen at 10/L by mask
D. Change the maternal position - ANSWER✔️-D. Change the maternal
position
10.A postpartum client who is Rh-negative refuses to receive Rho (D) immune
globulin (RhoGam) after delivery of an infant who is Rh-positive. Which
information should the nurse provide this client?
A. RhoGam is not necessary unless all her pregnancies are Rh-positive
B. The R-positive factor from the fetus threatens her blood cells
C. The mother should receive RhoGam when the baby is Rh-negative
D. RhoGam prevents maternal antibody formation for future Rh-positive
babies - ANSWER✔️-D. RhoGam prevents maternal antibody
formation for future Rh-positive babies
11.A primigravida arrives at the observation unit of the maternity unit because
thinks is in labor. The nurse applies the external fetal heart monitor and
determines that the fetal heart rate is 140 beats/minute and the contractions
are occurring irregularly every 10 to 15 minutes. What assessment finding
, confirms to the nurse that the client is not labor at this time? - ANSWER✔️-
Contractions decrease with walking.
12.A primipara has delivered a stillborn fetus at 30 weeks gestation. To asses
the parents in the grieving process which intervention is most for the nurse
to implement ?
A. explain the possible cause of the fetal demise
B. Provide a time for the parents to hold their infant in privacy
C. Encourage the parents to seek counseling within the next few weeks
D. Assist the couple to request autopsy - ANSWER✔️-B. provide a time
for the parents to hold their infant in privacy
13.What is the priority nursing assessment immediately following the birth of
an infant with esophageal atresia and a tracheoesophageal (the) fistula ?
A. body temperature
B. level of pain
C. time of first void
D. number of vessels in the cord - ANSWER✔️-A. body temperature
14.What is the most important assessment for the nurse to conduct following
the administration of epidural anesthesia to a client who is at 40-weeks
gestation?
A. Level of pain sensation
B. Station of presenting part
C. Variability of fetal heart rate
D. Maternal blood pressure - ANSWER✔️-D. Maternal blood pressure
15.A 34-week primigravida with pregnancy induced hypertension (PIH) is
receiving Ringer's Lactate 500 ml with magnesium sulfate 20 grams at the
rate of 3 grams/hour. How many ml/hour should the nurse program the
infusion pump? (Enter numeric value only)
A. 120
B. 70
C. 65
D. 75 - ANSWER✔️-D. 75
16.A mother of a 3-year-old boy has just given birth to a new baby girl. The
little boy asks the nurse, "Why is my baby sister eating my mommy's
breast?" How should the nurse respond? (Select all that apply)